The ability to become sexually aroused sounds like a good thing, right? Well, under normal circumstances, it absolutely is! But it’s true that you can have too much of a good thing. Imagine if you persistently experienced symptoms of sexual arousal … all the time. This condition, known as persistent genital arousal disorder (or PGAD), is unusual but it happens — and it can significantly interfere with patients’ lives.

PGAD can affect anyone, but is most commonly seen in women. It causes unrelenting, unwanted and spontaneous arousal of the genitals without any sexual activity, stimulation or interest in sex. Unfortunately, many people who suffer from PGAD may feel ashamed of their symptoms. But at Pelvic Pain Doc, we want to assure you there is no reason to be embarrassed. PGAD is not your fault and we can help you find relief.

So how can you tell if you have persistent genital arousal disorder? What causes PGAD and how can you treat it? Here, New York’s pelvic pain specialist Dr. Sonia Bahlani shares all.

What is Persistent Genital Arousal Disorder?

Persistent genital arousal disorder is an often misunderstood pelvic pain condition that refers to unrelenting, unwanted, persistent, intrusive and spontaneous sensations of arousal in the genitals in the absence of conscious thoughts of sexual desire or interest. For women, this includes arousal of the clitoris, vulva, perineum, nipples and/or anus. In men, this includes persistent erection lasting longer than several hours and is often called priapism.

The symptoms of persistent genital arousal disorder are difficult to live with and can affect all areas of your life, both personal and professional. If you think you might be suffering from PGAD, consider the following symptoms. Since this condition mostly affects women, we’ll focus on how women experience PGAD (we’ll talk about PGAD in men later on).

Pulsating, pounding and/or throbbing sensations in the clitoris, vulva, perineum, nipples and/or anusPressure, fullness or discomfort in the clitoris, vulva, perineum and/or anusAbsence of conscious sexual desire or interest

However, persistent arousal alone is not enough for a diagnosis. To diagnose persistent genital arousal disorder, we also need to look at five important factors:

Arousal should last for an extended period of time (hours to months)There should be no other cause for genital arousalGenital arousal should be unrelated to feelings of sexual desireThe sensation of arousal should feel intrusive, unwanted and distressingArousal should be persistent, even after orgasm

If this potentially describes what you have been feeling, you may be suffering from persistent genital arousal disorder. We urge you to contact a pelvic pain doctor to discuss your options if these symptoms sound familiar.

What Causes PGAD?

The first thing most patients want to know is, “What’s causing my PGAD?” Persistent genital arousal disorder is a multifactorial condition — meaning it has many concurrent contributing factors — so understanding its causes also requires a multifactorial approach.

PGAD is associated with neurological, vascular, physiological, pharmacological and psychological causes. Neurologic causes of PGAD may include epilepsy, trauma or post-surgical interventions. Pharmacologic causes may include the use of certain antidepressants, such as trazodone, or to the sudden withdrawal of selective serotonin reuptake inhibitors (SSRIs).

Specific neuropathic conditions such as pudendal neuralgia are also believed to cause persistent genital arousal disorder. Stress, anxiety, depression and past sexual trauma may also contribute to the development of PGAD.

How to Treat Persistent Genital Arousal Disorder

To treat persistent genital arousal disorder, we need to consider the patient’s entire history, including lifestyle, medications, behaviors and psychological state. We must also first understand the cause of PGAD for the specific patient before we can appropriately treat it.

Treatment will depend on the underlying cause of persistent genital arousal disorder and usually involves a combination of lifestyle changes, physical intervention and medications. Treatment may include:

Oral medications, suppositories, and topical medicationsMasturbation to orgasm (however, this typically only provides temporary relief and is still considered controversial)Numbing gelsTranscutaneous electrical nerve stimulation (TENS), a treatment that uses electrical currents to help alleviate nerve painAntidepressantsCounseling, psychotherapy or cognitive behavioral therapy

Persistent Genital Arousal Disorder in Men

As we mentioned, men can have PGAD, though it is not as common as it is for women. PGAD in men is often called priapism and refers to persistent erection of the penis that lasts for four hours (or more) and is not related to sexual stimulation. Priapism is usually painful and prompt treatment is necessary to prevent lasting tissue damage.

There are two types of priapism: ischemic and non-ischemic. In addition to prolonged erection without stimulation, ischemic priapism is characterized by a rigid penile shaft with soft tip and progressive pain. With non-ischemic priapism, the penis is erect but not fully rigid.

If you have an erection lasting more than four hours, in the absence of sexual interest or stimulation, you need to seek emergency care. The treatment for ischemic vs non-ischemic priapism differs, so an accurate diagnosis is key to recovery. Whatever the cause of priapism, a pelvic pain specialist or emergency doctor can help.

At Pelvic Pain Doc, we understand that pelvic pain and sexual disorders can bring up many different emotions, from guilt and shame to frustration and anxiety. You don’t deserve to live like this and treatment can help you get back to feeling like yourself. If you think you’re suffering from persistent genital arousal disorder, contact Pelvic Pain Doc to book a complimentary consultation. We’re here to help.

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